Healthcare Provider Details

I. General information

NPI: 1659558948
Provider Name (Legal Business Name): PAMELA LEMMON BLAUFARB NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SAN PABLO AVE SUITE 400
ALBANY CA
94706-1127
US

IV. Provider business mailing address

500 SAN PABLO AVE SUITE 400
ALBANY CA
94706-1127
US

V. Phone/Fax

Practice location:
  • Phone: 415-272-2058
  • Fax: 510-525-9020
Mailing address:
  • Phone: 415-272-2058
  • Fax: 510-525-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: